The Affordable Care Act (ACA), also known as ObamaCare, faced a lot of challenges in the initial 2013-2014 rollout. As a result, Americans are wondering how their policies will be handled in the next enrollment period, which begins November 15, 2014.
The Obama administration has put policies in place to help you maintain health insurance coverage with minimal concerns. Insurance companies will send information in advance of open enrollment, allowing you time to review your coverages and make sure they meet your needs. Many policies will renew automatically if no action is taken. The Obama administration is hoping this will help avoid the issues that plagued the initial rollout. These policies apply to the federally-facilitated Marketplace and many state-run Marketplaces may also offer these options.
Policy Changes in 2015
The Marketplace may allow automatic renewal for Americans who don’t want to change plans, but it may not be the best option. Plans that were the lowest price in 2014 may not be going into 2015, as most plan premiums are expected to change.
In addition, there may be other changes to the policies, including the medical provider network, cost-sharing structure, and prescription coverages. It is important to review all renewal documents closely and make sure to note any and all changes, and compare the plan to other options in the Marketplace.
Finally, some plans will be discontinued in 2015 and replaced with a different, though similar, option. For those facing this change, it’s especially important to understand what the differences are and how the plan compares to other Marketplace options.
In the end, you may choose to continue with your current policy, especially if continuity of care is your main concern. If that’s the choice you make, you can let it automatically renew or notify the company directly that you have chosen to continue the policy.
Changes in Subsidies in 2015
Policies won’t be the only change in 2015 – subsidy amounts will also change. The tax subsidy you receive helps you afford your health insurance. The government determines your subsidy amount, based on your income and the cost of coverage available in your Marketplace, and applies it monthly to your insurance premium.
Those who earn between 100% – 400% of the federal poverty level will be eligible for monthly assistance with their insurance premium. Those earning between 100% – 250% of the federal poverty level will also be eligible for assistance with cost-sharing, such as copayments and deductibles.
In the 2014-2015 enrollment period, the 2014 federal poverty level will be used, which is $23,850 for a family of four. This change could mean that you are eligible for a higher subsidy amount than you were previously. It’s important to pay attention to how the update affects your monthly payments so you can make an informed decision about coverage.
If you expect any income or family size changes in 2015, you will need to report that through the Marketplace to avoid having an overpayment or underpayment of your tax subsidy. If you make more than expected and don’t report it, you could owe money at tax time. If you make less than expected and the Marketplace doesn’t find out, you could miss out on monthly help with your insurance bill. Additionally, consumers who purchased through the federally-facilitated Marketplace will receive a notice from the Marketplace regarding how to obtain an updated tax credit amount.
A change in your subsidy amount can help you afford a more comprehensive insurance plan, or conversely may mean that you need to downgrade to keep your personal finances in check. Either way, it’s important to review your options.
In 2015, many policies will automatically renew if action is not taken to change plans. However, due to changes in policy terms, monthly premiums, and subsidy amounts, it is wise to review all your Marketplace options during open enrollment. This will allow your household to enter 2015 knowing that your health is fully protected.